Provider Demographics
NPI:1093870388
Name:SHTERN, MARINA G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:G
Last Name:SHTERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:39 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-482-3035
Mailing Address - Fax:516-482-3035
Practice Address - Street 1:107 21 QUEENS BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-520-0700
Practice Address - Fax:718-520-7180
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212461207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH53321Medicare UPIN
NY06627GMedicare ID - Type Unspecified